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UNTHSC Scholar is an open access repository of the intellectual output and publicly available materials of the university. UNTHSC Scholar provides stable access to data, highlights community partnerships and engagement, and enables discovery of these works by the international scientific community. It preserves the history, growth and innovation of the University of North Texas Health Science Center as an institution.


Recent Submissions

Interactive Images in Library Instruction: A Case Study
(Routledge - Taylor & Francis Group, 2024-02-01) Pierce Farrier, Katie; Dowd, Abby; Van Der Volgen, Jessi
This paper discusses the design and implementation of the H5P image hotspots and describes additional use cases for library instruction in order to teach learners from across the country on how different spaces can be used to create private, accessible areas where patrons can conduct telehealth appointments. The Network of the National Library of Medicine created an online class using H5P image hotspots to allow learners to virtually explore a physical space. The class used Moodle, an open-source learning platform, and H5P image hotspots to demonstrate how libraries implemented telehealth programs.
Exploring Freely Available Data Tools to Support Open Data and Open Science
(Routledge - Taylor & Francis Group, 2024-01-15) Nieman Hislop, Christine; Pierce Farrier, Katie; Roth, Elizabeth
Librarians support researchers by promoting open science and open data practices. This article explores five freely available tools that support and facilitate open science practices. Open Science Framework provides a platform for project management, data sharing, and data storage. OpenRefine cleans and formats data. DMPTool has templates for data management and sharing plans that comply with funder mandates. The NIH Common Data Elements is a repository for standardized data elements, and finally, the NLM Scrubber is a tool for de-identifying clinical text data. Information professionals can add these tools to their repertoire and share them with researchers at their institution.
The Evaluation of Elongated Styloid Processes in regard to possible Clinical and Pathological Outcomes - A Case Series
(2024-03-21) Cornejo, Federico; Desai, Ananya; Cheng, Jack; Chen, Liling; Cruise, Forrest; McKean, John; Menegaz, Rachel; Crowe, Nicole
Background: Eagle’s syndrome (ES) is defined as elongation or ossification of the styloid process that may compress adjacent anatomy, producing variable symptomology. ES is subclassified into Classic ES or Stylocarotid syndrome. Classic ES may present asymptomatically, or with dull, recurring cervicofacial pain, and Stylocarotid syndrome may present with parietal headaches, and presyncope/syncopal episodes. The etiology of the abnormal ossification of the styloid process or stylohyoid ligament is unknown but likely caused by reactive metaplasia/hyperplasia or anatomical variance. Although a styloid process greater than 30mm in length is generally considered elongated, clinical guidelines for measuring styloid process length, and specific histological characterizations for ES have not been formally established. However, elongated styloid processes can be structurally classified as uninterrupted (one unsegmented process), pseudo-articulated (two parts in close proximity), or segmented (three or more parts). Styloid processes may also be classified into four calcification patterns including outlined calcification, partial calcification (multiple bone pieces surrounded by a continuous calcified process), nodular calcification (segmented, bumpy surfaced bone pieces due to thickened calcifications), and complete calcification. However, no clinical correlation has been identified between patient presentation and morphology/calcification pattern. Case Information: A 62-year-old deceased Caucasian male (147lbs / 5’6”) with an elongated stylohyoid process was discovered during routine dissection. Medical history was significant for liver and renal disease. Cause of death was reported as “chronic alcoholism”. Social history was significant for off-and-on incarceration for more than 40 years, and chronic alcohol, tobacco, and non-prescription illicit drug use of unknown types, amount, frequency, or duration. No other history was available. The styloid processes of the patient were imaged in-situ using a 3D C-arm X-ray machine. Furthermore, bilateral styloid processes were collected from the patient and seven other anatomical donors (6 M/1 F, age range 61-76) by detaching them from the base of the temporal bone and excising portions of the hyoid bone to maintain the stylohyoid ligament intact. Calipers were used to measure the length of the styloid processes and their calcifications. The primary donor exhibited elongated, asymmetrical processes (31.9 mm left, 37.8 mm right). Significant variation in styloid process lengths were observed in this sample (mean length 28.5 mm; standard deviation 13.5 mm; range 14.5-68.3 mm). Generally, the styloid processes demonstrated bilateral asymmetry across the sample. This asymmetry was notably pronounced in one donor with a significantly elongated styloid process (20.5 mm left, 68.3 mm right), co-occurrent with thyroid cartilage calcification. Conclusions: There is presently no consistent diagnostic measure of an elongated stylohyoid process available for providers to assess patient risk for Eagle’s Syndrome or its future progression. In this study, styloid length was found to be a continuous variable with no clear “cutoff” between elongated and normal lengths at 30mm. Furthermore, the lack of histological evidence detailing the condition's progression hinders diagnostic measures and risk assessment. We recommend further studies perform histologic analysis to better understand the progression of elongated styloid processes. Based on additional samples, a standardized diagnostic measurement can be created to improve treatment regimens and health risk screenings.
Exploring Anatomical Variations: A Case Study of an Aortic Arch and Left Superior Intercostal Artery Variants with Clinical Considerations
(2024-03-21) Stokes, Cameron; Hall, Alex; Shevtsov, Allison; Lau, Azelia; Lovely, Rehana
Background: In its usual pattern, the aortic arch has three branches, namely, from right to left, brachiocephalic trunk, left common carotid artery, and left subclavian artery. Normally, as one of the branches off the left subclavian artery, the costocervical trunk gives off the left superior intercostal artery. The aim of this case is to describe a variation in the aortic arch wherein the left common carotid artery branches from the brachiocephalic trunk, with an additional rare finding of the left superior intercostal artery branching directly from the left subclavian artery. Case Information: As part of the cadaveric anatomy laboratory requirement of the Cardiopulmonary System Course (MEDE7615), our group performed a dissector-directed study of the thoracic cavity of a 67-year-old female donor to the UNTHSC Willed Body Program. Upon removal of the anterior part of the rib cage and subsequent exposure of the mediastinum and its contents, a variation in the branching pattern of the aortic arch in the superior mediastinum was dissected, cleaned, and identified. Following dissection of the aortic arch and its branches, we observed variations in the aortic arch and left superior intercostal artery. In this donor, the left common carotid artery branched from the brachiocephalic artery. This created only two vessels off the aortic arch rather than the three typically seen. We also observed that, on the left side, the superior intercostal artery branched directly from the subclavian artery and not from the costocervical trunk of the subclavian artery. This variant placed the left superior intercostal artery in a position more inferior and posterior in the upper part of the left pleural cavity. Conclusion: Awareness of the aortic arch and left superior intercostal artery variations are clinically relevant to ensure prevention of potential surgical errors and ambiguity when viewing radiologic images.
Long-term Follow-up of Hip Resurfacing Arthroplasty Patients: A Comprehensive Review of Outcomes Over 15 Years
(2024-03-21) Wong, Zachary; Saluja, Anand; Spaan, Jonathan; Su, Edwin
Purpose: Hip resurfacing arthroplasty (HRA) has emerged as a promising alternative to total hip arthroplasty (THA) for managing severe osteoarthritis, especially in younger, active males seeking a return to high impact activities. While short to medium-term follow-up studies have demonstrated favorable clinical outcomes and survival rates, there is increasing interest in the long-term durability of HRA, in terms of implant survivorship and patient outcomes and attitudes. The existing body of literature on HRA longevity is predominantly limited to follow-up periods of up to 10 years. As such, the purpose of this study was to evaluate the long-term survivorship of HRA with a minimum follow-up period of fifteen years. Methods: A retrospective review of hip resurfacing arthroplasties performed by a single surgeon at a high-volume surgical center between 2006-2008 was conducted. Given that the majority of these patients were male, we elected to focus exclusively on male patients to control for potential confounding factors related to sex and standardize our findings. Patient demographics were collected including age, BMI, and laterality. Patient reported outcome measures (PROMs) including Hip Disability and Osteoarthritis Outcome Score, Joint Replacement (HOOS-JR), Harris Hip Score (HHS), Visual Analogue Scale (VAS), and UCLA Activity Scores were collected at fifteen years post-operation. Subject satisfaction surveys were also collected, and Kaplan-Meier survival analyzed implant revisions. Results: A total of 312 patients (369 hips) out of 470 (543 hips) with a minimum 15-year follow up were included in this study, representing a follow-up rate of 66.4%. The mean age at surgery was 50.5 ± 7.8 years and the mean BMI was 27.9 ± 4.3 kg/m2. The mean scores for HOOS JR, HHS, VAS, and UCLA activity scores at final follow-up were 97.5 ± 6.7, 96.7 ± 8.3, 0.3 ± 0.9, and 7.9 ± 1.9, respectively. Out of the 369 HRA implants, 24 were revised to total hip arthroplasty, indicating 93.5% survivorship. Excluding patients who required revision, 98.9% of patients expressed satisfaction with the procedure. Conclusions: Positive outcomes in PROMs and subject satisfaction scores accompanied by high implant survival, indicate that the metal-on-metal HRA procedure exists as a safe and effective solution for end-stage osteoarthritis in young (50.5 ± 7.8 years) male patients at long-term follow-up. Favorable outcomes persisting 15-years after primary procedure suggests that HRA may serve as a viable alternative to THA, its longstanding counterpart, at high-volume centers with proper expertise of the procedure. This avenue warrants further exploration in the future of our study, with potential implications for the optimization of patient care and surgical decision-making in this population.